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小儿伤寒临床表现往往不典型,容易造成误诊。我院1979～1982年误诊小儿伤寒13例,现将有代表性的病例分析如下:一、伤寒误诊为上呼吸道感染、肺炎:宋××,女,12岁,因发热、咳嗽、无力、食欲差19天,于1982年10月13日入院。发病后当地医院曾诊断为“上呼吸道感染”,给一般对症治疗。10月10日起咳嗽加剧,痰量增加,伴气急,给青、链霉素肌注3天无效而入我院。体检:体温39℃,脉搏138次/分,神志清,口唇稍发绀,呼吸急促,轻度鼻翼扇动,双侧扁桃腺Ⅱ°肿大,胸前无皮疹,两肺满布湿罗音,心音弱而快,腹软,肝脾未触及.胸透:两肺有斑片状阴影。血象白细胞8300,中性64%,淋巴34%,酸性2%。当时该生产队流行伤寒,故诊断为伤
Clinical manifestations of pediatric typhoid often atypical, easily lead to misdiagnosis. My courtyard misdiagnosis of 13 cases of pediatric typhoid fever from 1979 to 1982, the representative cases are as follows: First, typhoid fever misdiagnosed as upper respiratory tract infection, pneumonia: Song × ×, female, 12 years old, due to fever, cough, weakness, loss of appetite Difference 19 days, on October 13, 1982 admission. After the onset of the local hospital had been diagnosed as “upper respiratory tract infection” to the general symptomatic treatment. October 10 increased cough, increased sputum volume, with acute gas, to green, streptomycin 3 days invalid intramuscularly into our hospital. Physical examination: Body temperature 39 ℃, pulse 138 beats / min, conscious mind, slightly cyanotic lips, shortness of breath, mild nose flap, bilateral tonsil enlargement, no rash chest, lungs covered with wet rales, Weak and fast, abdomen soft, liver and spleen not touched.Crustal: lungs have patchy shadows. Blood white blood cells 8300, 64% neutral, lymphatic 34%, acid 2%. At that time, the production team was endemic and typhoid fever was diagnosed